Ravikumar Shamili Pammi, Kaliyan Arivoli, Jeganathan Sathya, Manjunathan Reji
Department of Paediatric, Chengalpattu Government Medical College and Hospital, Chengalpattu, Tamil Nadu, India.
Multi-disciplinary Research Unit, Chengalpattu Government Medical College, Chengalpattu, Tamil Nadu, India.
Heliyon. 2022 Aug 9;8(8):e10165. doi: 10.1016/j.heliyon.2022.e10165. eCollection 2022 Aug.
Multiple parameters are available to predict the outcome of critically sick neonates admitted in neonatal intensive care unit (NICU). Main aim of the study is to validate the role of TOPS, especially the post-transport TOPS score as a simplified assessment of neonatal acute physiology in predicting mortality among transported neonates admitted at level III NICU. Also, to compare the efficiency of post transport TOPS score with SNAP II PE in predicting mortality.
A prospective study carried out with 85 neonates transported from various primary health care centres to level III NICU. Physiological status of the neonates was assessed with the help of pre and post transport TOPS scores. Post-transport TOPS score was recorded immediately after the admission and SNAP II PE within 24 h of admission at level III NICU. Receiver operating characteristics analysis was performed to observe the mortality prediction efficiency of TOPS score and was compared with SNAP II PE.
64 neonates were died due to asphyxia and preterm birth (32%) related complications. Strong significant association with the mortality rate was found between the total post transport TOPS score (0.001) and SNAP II PE (0.003). The AUC, sensitivity and specificity of post transport TOPS score for a cut-off value ≤7 were 0.900, 87.5% and 80% and significant (<0.001) and for SNAP II PE for a cut-off value >12 were 0.913, 75.5% and 100% and is significant (<0.001).
TOPS score, especially the post transport TOPS score has an equally good prediction capacity of mortality similar like SNAP II PE among mobilised critically ill neonates. Hence, the TOPS score can be used as a simple and effective method to predict mortality risk among transported neonates immediately after admission at level III NICU.
有多个参数可用于预测入住新生儿重症监护病房（NICU）的危重新生儿的预后。本研究的主要目的是验证TOPS的作用，特别是转运后TOPS评分作为新生儿急性生理学的简化评估方法，在预测入住三级NICU的转运新生儿死亡率方面的作用。此外，比较转运后TOPS评分与SNAP II PE在预测死亡率方面的效率。
对85例从各基层医疗中心转运至三级NICU的新生儿进行了一项前瞻性研究。借助转运前和转运后TOPS评分评估新生儿的生理状态。转运后TOPS评分在入院后立即记录，SNAP II PE在三级NICU入院后24小时内记录。进行受试者操作特征分析以观察TOPS评分的死亡率预测效率，并与SNAP II PE进行比较。
64例新生儿死于窒息和早产（32%）相关并发症。转运后TOPS总分（0.001）和SNAP II PE（0.003）与死亡率之间存在强显著关联。转运后TOPS评分截断值≤7时的曲线下面积（AUC）、敏感性和特异性分别为0.900、87.5%和80%，差异有统计学意义（<0.001）；SNAP II PE截断值>12时的AUC、敏感性和特异性分别为0.913、75.5%和100%，差异有统计学意义（<0.001）。
TOPS评分，尤其是转运后TOPS评分，在危重新生儿中对死亡率的预测能力与SNAP II PE相当。因此，TOPS评分可作为一种简单有效的方法，用于预测三级NICU入院后立即转运的新生儿的死亡风险。
